Can Staying at Home be Saving Lives and Avoiding Killing? COVID-19, Lockdowns and the Doing/Allowing Distinction

Like many others around the world, I have spent a considerable amount of 2020 in “lockdown” in response to the COVID-19 pandemic. Lockdown and its purpose have been summarized in five words that have echoed from the mouths of politicians, public health bodies, and social media accounts of large companies and private citizens: “Stay at home. Save Lives.” Many countries across the world have had similar handy little summaries. But some philosophers have objected to this slogan. Helen Frowe,¹ for example, argues that talk of saving lives is misleading. She argues that staying home is not in fact saving lives. Instead, we stay home to avoid infecting others with the virus—in other words, we stay home to avoid killing people. This matters because killing and letting die have very different moral statuses. The difference between killing and letting die is an example of what is a more general distinction in moral philosophy between doing and allowing harm. This distinction matters morally because we are required to bear much stronger costs to avoid doing harm than to save someone from harm. Frowe thus argues that framing obeying lockdown as saving lives leads us to make mistakes in weighing the costs and benefits of maintaining lockdown. If we think of lockdown as saving lives, we will try to work out how much cost we should be prepared to bear to prevent the spread of the virus by thinking about how much we are required to bear to save lives in other situations. Frowe criticizes Alec Walen and Bashshar Haydar for assuming that that lockdown is saving lives in their arguments about how to assess whether to maintain lockdown. ^{2, 3}

I think that Frowe is correct to criticize Walen and Haydar for ignoring the difference between doing and allowing harm. In general, she is right that thinking of lockdown as a standard case of saving lives is incorrect and will lead to underestimation of the costs that we should bear to prevent the spread of the virus. However, at least some lockdown measures are not standard cases of refraining from doing harm. The feeling that we are doing something to combat the virus is not wrong. As I will argue, some lockdown measures are neither standard cases of saving nor standard cases of refraining from doing harm, but belong to a strange type of case that involves both saving and refraining from doing harm. This means that neither analogies with standard cases of saving others nor analogies with standard cases of avoiding harming others are appropriate when working out whether to maintain lockdown.

The Saving Lives Model

Walan and Haydar argue that how much we should be prepared to sacrifice to contain the COVID-19 virus depends on whether this crisis is a one-off emergency or a new normal. Their argument draws on the following thought experiment:

Bugatti: You have invested your retirement savings in a Bugatti, an extremely rare and valuable car. One day, while you are out for a walk, you see a boulder heading toward a small child. You cannot reach the child, but you can divert the boulder away from her. Doing so will send the boulder rolling toward your Bugatti.

Most people think that you are morally required to divert the boulder, even though this will destroy your precious car. This reaction becomes more complicated when we reflect on whether it would have been okay for you to keep your car if it had not been for the boulder incident. After all, most people think that it would have been permissible for you to keep the car in that case. And yet, you could have sold the car and saved many children’s lives by donating the money to charity. Why are you required to sacrifice your Bugatti to save one child from a boulder but not to save many children from poverty? Walen and Haydar argue that there is a difference between exceptional and ongoing ethical demands. You can be required to sacrifice your car in an emergency because such a demand is compatible with having your own plans and projects. The requirement to sell the car to save children in poverty makes sense only as an ongoing demand to sacrifice your own plans and projects whenever this could save lives. This amounts to not being allowed to have your own plans and projects—or indeed your life—in the first place.

Walden and Haydar argue that we need to bear this distinction in mind when assessing lockdown measures: if we think of the COVID19 crisis as a one-off emergency, we should be prepared to make significant sacrifices to stop the spread of the virus; on the other hand, if the pandemic becomes “a new normal,” then we need to adjust to allow people to get on with their lives.

Frowe’s Criticism

Frowe argues that Walden and Haydar’s approach is fundamentally misguided. They assess restrictions aimed at containing the virus by asking how much we can be required to sacrifice to save lives. “But I do not save your life if I do not infect you with COVID-19. Rather, I refrain from harming you. And the costs that I may be required to bear to refrain from harming you are considerably greater than the costs that I may be required to bear to save you.” ¹

Frowe uses two more thought experiments to support this claim:

Drowning: Alice is about to drown. Betty can save Alice but will lose her own arm in the process.

Fleeing: Betty is fleeing an attacker who will cut off her arm if he catches her. The only way she can escape is by lethally trampling over Alice, who is an innocent bystander.

As Frowe points out, most people will think that Betty is permitted to let Alice drown rather than suffer the loss of her arm—but that she may not kill Alice in order to save her own arm. Alice must bear greater costs to avoid harming Betty than she would be expected to bear to save Betty’s life. This means that if lockdowns prevent us from harming others, we cannot work out if the lockdown is justified by thinking about the sacrifices that we would be required to bear to save others. Instead, Frowe argues, we must assess lockdowns by thinking about the costs we would be required to bear to avoid harming others—or more precisely, the costs that we would be required to bear to avoid imposing significant risks of harm onto others.

Could Staying Home Still be Saving Lives?

I think Frowe is correct to criticize Walen and Haydar. If I go about my normal life during a pandemic, I risk infecting others with the virus. That is doing harm to them. We should not think about this by analogy with cases like the Bugatti one, where you save the child from an independent threat that would have killed her even if you and your Bugatti had never existed. Nonetheless, I also think there is something right in the slogan: “Stay Home; Save Lives.” When you stay home you are doing something to reduce infection. This matters because it means that at least some lockdown measures fall in a peculiar class of behavior that is morally distinct both from standard cases of doing harm and from standard cases of merely allowing harm.

Before I explain why I do think staying home is doing something (in other words, saving lives), I want to discuss a few unsound reasons for thinking this. We might think that when we stay home we are doing something to save lives because staying home is costly, because it requires a lot of psychological effort, because it is different from our normal routine, or because to safely stay home we have to perform many actions and make lots of plans. All this might be true, but none of it prevents the scenario from counting as a standard case of avoiding harming rather than doing something to prevent harm. After all, in Frowe’s fleeing case, a paradigm case of avoiding harming, it is extremely costly for Betty not to trample over Alice and thus to avoid harming her: Betty’s arm is at stake. It may well require significant psychological effort for Betty not to trample over Alice. After all, the attacker sounds pretty terrifying! Of course, trampling people when fleeing from an attacker is unlikely to be part of Betty’s daily routine. So, consider a different example: passive smoking. If I smoke near someone and make them inhale my smoke, then I am doing something that imposes a risk of harm on them. This is a standard case of doing harm, even if smoking is part of my normal routine and I must actively use many strategies to prevent myself from smoking.

So why do I think some lockdown measures count as doing something to save others? The answer is the degree of restriction on my behavior. Some lockdown measures restrict my behavior so much that complying with them makes some positive fact about myself hold. For example, consider restrictions on movement. The most extreme of these require me to stay at home. If I live at 221b Baker Street, I am required to stay at 221b Baker Street. That I am at 221b Baker Street is a positive fact about my location. It tells you where I am. By contrast, consider the fact that I am not in Scotland. This is a negative fact about my location. It does not tell you where I am—it merely rules out some place as a possible location. So, staying at home is making a positive fact about my location hold. On my analysis of the doing/allowing distinction,⁴ making a positive fact about one’s location hold counts as doing something.⁵ So if a lockdown measure is restrictive enough that it requires me to make a positive fact about my location hold, complying with it will be doing something to prevent deaths. If we are doing something to prevent deaths, then we can think of ourselves as saving lives.

Nonetheless, if I do go out and infect someone, I am still doing harm. I sit on a bus; I breathe, propelling particles of the virus into the air; I touch my mouth and transfer virus particles to my hand, then to the back of the seat; Someone else breathes in my virus particles or transfers them to their mouth after touching the seat. The virus multiplies in their bodies and they pass it on to their family, who pass it on and on. The numbers of infections, of severe cases, of hospitalisations, of permanent disabilities, and of deaths, mount exponentially. My action clearly initiates a sequence of positive facts leading to harm to others. There is not some independent threat which I could prevent but decide not to. Nor is this a case of withdrawing some barrier that could have prevented an independent threat from causing harm. My behavior is the threat. On any account of harm, I should count as doing harm.

So the doing/allowing distinction does not apply nicely to sufficiently restrictive lockdowns. Instead, such lockdowns are examples of a strange type of case. In cases of this type, for reasons outside the control of either agent or victim,⁶ the agent must perform some action to avoid being relevant to some harm. If the agent performs the protective action, they will count as saving the potential victim; but on the other hand, if they do not perform the protective action, they will count as doing harm to the victim. The protective action is both saving and avoiding harming.

Cases of saving and avoiding harming are morally distinct from standard cases of not doing harm and standard cases of saving. In my view, the doing/allowing distinction is morally relevant because for anything, even our own bodies, to belong to us requires protection from two types of imposition. You impose on me when your behavior or your needs reach beyond your own sphere and interferes with what is mine. Causal imposition involves your behavior interfering with what is mine. Normative imposition involves your needs interfering with me, placing demands on me to put what is mine at your use instead of my own use. Genuine belonging requires protection against both types of imposition: my car is not really my car if you can take it or crush it whenever this would benefit you more than it would me; my car is also not really my car if I am required to use it to drive anyone who needs a lift wherever they want to go. (These protections can be limited: my car is still my car if I would be required to use it to drive someone to the hospital if they had a heart attack in front of me.) Doing harm causally imposes on the victim. Requirements to prevent harm normatively impose on the agent. So in order to recognize genuine belonging, we end up with both strong constraints against doing harm and permissions to allow harm (except in special circumstances).

In the strange cases I am interested in, the two types of protection clash. If my behavior is not restricted, then I am causally imposing on the victim. But if my behavior is restricted, then the victim is normatively imposing on me. The unfortunate circumstances mean that there must be imposition either way. Working out how to respond to this is a delicate balancing act. The costs that we are required to bear in such cases are unlikely to be quite the same as in either standard cases of avoiding doing harm or standard cases of saving. There also might be other differences. Governments may be permitted or even required to prevent some citizens from causally imposing on others. This would justify legally requiring someone to stay home to save lives when it would not be permissible for the government to compel individuals to save fellow citizens in standard saving cases. On the other hand, because such requirements involve normative imposition and the set up was outside the individual’s control, the government might have extra strong duties to protect those who are imposed on in this way from suffering undue costs, for example, by providing income support.

Conclusion

Sufficiently restrictive lockdown measures may involve both saving others and avoiding harming others. This means that neither analogies with standard cases of saving others nor standard cases of avoiding harming others are appropriate when working out whether to maintain lockdown—and indeed for many other ethical questions surrounding lockdown.

—Fiona Woollard

Fiona Woollard is professor of philosophy at the University of Southampton. Her research interests include normative ethics, applied ethics, the philosophy of sex, and the philosophy of pregnancy, birth, and early motherhood. Her monograph “Doing and Allowing Harm” is available from Oxford University Press.

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